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Evidence checklist

Vocal Cord Paralysis

DC 651938 CFR § 4.97Respiratory

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 3 collected
Laryngoscopy confirming vocal cord immobilityCritical

Flexible laryngoscopy or stroboscopy documenting unilateral or bilateral vocal cord paralysis or paresis, including the position of the paralyzed cord (paramedian, lateral), which affects voice and breathing impact.

Private provider · independent opinion
Nexus opinion linking vocal cord paralysis to service ("at least as likely as not")Critical

A medical opinion connecting the vocal cord paralysis to an in-service surgical complication (thyroid or cervical surgery), traumatic neck or chest injury, intubation injury, or nerve damage from a service-connected condition.

Private provider · independent opinion
Speech pathology evaluation with acoustic voice analysisCritical

Formal voice evaluation documenting the degree of hoarseness, breathiness, diplophonia, or aphonia, maximum phonation time, and impact on communication. Objective acoustic measures document severity.

Private provider · independent opinion
02

Treating physician

0 of 2 collected
CT or MRI of neck and chest to identify causative lesion

Imaging to identify the underlying cause of paralysis — particularly important for recurrent laryngeal nerve paralysis (CT from skull base to mediastinum) to document service-related pathology.

Your treating provider · written request
Documentation of aspiration or dysphagia (if applicable)

Modified barium swallow study or clinical documentation of aspiration or swallowing difficulty, which may occur with bilateral paralysis or high vagal lesions.

Your treating provider · written request
03

Treatment records

0 of 1 collected
Treatment records (voice therapy, medialization, injection laryngoplasty)

Records documenting voice therapy, vocal cord medialization procedures, injection laryngoplasty or thyroplasty, or tracheotomy if bilateral paralysis caused airway compromise.

VA or private records · written request
04

Lay statements

0 of 1 collected
Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
05

Benefits questionnaire

0 of 1 collected
Completed DBQ Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, Larynx, and PharynxCritical

Standardized form capturing laryngoscopy findings, voice quality, aspiration status, and functional impact of vocal cord paralysis.

Provider-completed · VA DBQ formHow to get this →
06

Service records

0 of 1 collected
Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.

NPRC / milConnect · SF-180
Condition guideRating criteria and what VA looks forC&P exam prepWhat the examiner will askBuddy statement builderGuided VA Form 21-10210

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